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How to manage stoma granulomas

A stoma granuloma is a mass of hyper-granulated tissue that can form on or around a patient’s stoma

The exact cause of granulomas is often unknown2, but infections, inflammation, irritants, and foreign objects are all common contributors for stoma granulomas. These can include:

  • Sutures – from retained fragments, or a reaction to the suture material1,2,4 
  • Repeated trauma – from the opening of the ostomy appliance and/or the patient’s application or removal technique2,5 
  • Chronic irritation – from exposure to faecal output2,5,6,7 
  • Tight clothing or belts – which create friction in and around the mucocutaneous or stomal area.2 
  • An allergic reaction – to the stoma bag material5

Tips for preventing and managing granulomas

Although silver nitrate (which cauterises granulomas) is the most common treatment option for stoma granulomas, you can also help your patients make effective choices to minimise irritation and even prevent granulomas from occurring in the first place. These include:

  • Decreasing friction and trauma (to prevent bleeding)2 
  • Making sure their ostomy appliance fits correctly – resizing the stomal opening if you need to, or adding an ostomy seal2,3,4 
  • Applying a barrier paste to the mucocutaneous junction2 
  • Avoiding tight fitting clothing and belts over the peristomal and stomal area2
Eakin IQ

Featured Education. Evidence. Experience.

We’ve gathered the latest data to help you, and your patients, manage stoma granulomas. You’ll also find tips for preventing them, and the innovative eakin® products that can help.

Booklet

Find out how eakin® seals have helped stoma care nurses to successfully manage previously problematic stoma granulomas.

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Case studies

See the data on how switching to an eakin freeseal® has impacted the quality of life for a patient experiencing peristomal skin complications and hypergranulation.

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Poster

Gain an insight into how our eakin Cohesive®  stomawrap has prevented leaks and halved the number of changes for an active patient with a challenging stoma.

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Continue your learning

Continue your learning with a growing library of expert-led podcasts, webinars, white papers and clinical case studies, designed to help healthcare professionals deliver informed stoma care

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Common patient challenges

Patients may experience a range of challenges as they adjust to life with a stoma. Recognising these concerns is an important part of supporting long-term wellbeing and quality of life.

Supporting Acceptance & Adjustment

Adapting to life with a stoma can be a significant emotional adjustment. Patients may experience a sense of loss, uncertainty about the future, and difficulty accepting changes to their body, independence, and daily routine.

Supporting Positive Body Image

Changes in appearance, concerns about pouch security, and fear of leaks can affect confidence and self-esteem. These concerns may impact social participation, work, relationships, and overall quality of life.

Discussing Intimacy & Relationships

Many patients have concerns about intimacy and personal relationships following stoma surgery. Creating opportunities for open conversations can help address fears, build confidence, and support emotional wellbeing.

Supporting patients

Patients may experience a range of emotional challenges as they adjust to life with a stoma. Recognising these concerns is an important part of supporting long-term wellbeing and quality of life.

Encourage Open Conversations

Patients may be reluctant to discuss concerns around body image, relationships, intimacy, or emotional wellbeing. Creating a supportive environment where these conversations are welcomed can help patients feel heard, understood, and less isolated.

Promote Confidence & Independence

Developing confidence in stoma management can play an important role in emotional adjustment. Supporting patients to build skills, establish routines, and regain a sense of control can improve self-esteem and encourage greater independence.

Recognise When Additional Support Is Needed

While adjustment takes time, some patients may experience ongoing emotional distress or difficulties adapting to life with a stoma. Recognising when additional psychological or specialist support may be beneficial can help ensure patients receive the care they need.

Patient perspectives

Gain insight into the lived experience of people with a stoma and discover how they have adapted to everyday life.

Featured product

Supporting patient confidence

Confidence in stoma management can have a positive impact on emotional wellbeing. Helping patients achieve a secure fit may reduce concerns around leakage and support greater independence in everyday life.
Explore eakin Cohesive® seals

References
1. Beitz, J. M., & Colwell, J. C. (2014). Stomal and peristomal complications: Prioritizing management approaches in adults. Journal of Wound, Ostomy and Continence Nursing, 41(5), 445–454.
2. Johnson, T. (2010). Problematic stomas…Stoma granulomas. Colostomy Association Tidings Magazine.
3. Salvadalena, G. (2016). Peristomal skin conditions. In J. E. Carmel, J. C. Colwell, & M. T. Goldberg (Eds.) Wound, Ostomy and Continence Nurses Society core curriculum: Ostomy management (pp. 176–190). Philadelphia, PA: Wolters Kluwer.
4. Wound, Ostomy and Continence Nurses Society. (2010). Management of the patient with a fecal ostomy: Best practice guidelines for clinicians. Mt. Laurel, NJ: Author.
5. Dukes, S., Lowther, C., Martin, T., & Osborne, D. (2010). Guidelines for treating stoma granulomas at the mucocutaneous junction. Gastrointestinal Nursing, 8(1), 16–21.
6. Burch, J. (2014). Care of patients with peristomal skin complications. Nursing Standard, 28(37), 51–57. http://dx.doi.org/10.7748/ns.28.37.51.e8317
7. Lyon, C. C., & Beck, M. H. (2012). Chapter 97. Skin problems in ostomates. In L. A. Goldsmith, S. I. Katz, B. A. Gilchrest, A. S. Paller, D. J. Leffell, & K. Wolff (Eds.), Fitzpatrick’s Dermatology in General Medicine, 8e.

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